Hemp oil products are displayed during the Cannabis World Congress & Business Expo on June 17, 2016 in New York City.

Hemp oil products are displayed during the Cannabis World Congress & Business Expo on June 17, 2016 in New York City.

(Justin Sullivan / Getty Images)

Christy BrissetteSpecial to The Washington Post

Cannabis is making its way into more and more foods and beverages, thanks to its touted therapeutic benefits. In fact, no matter where you are in the United States, cannabis products are probably being sold in your grocery store - and it's perfectly legal. Because regulation hasn't kept up, this should be cause for concern no matter your politics. But before we go further, let me define what I mean when I say cannabis.

Cannabis is a plant that has been selectively bred into two distinct varieties: Hemp for its fiber and nutritious seeds; and marijuana for its medical and recreational uses.

Cannabis contains numerous compounds called cannabinoids. The most well-known cannabinoid, delta-9-tetrahydrocannabinol (THC), causes the high many people associate with cannabis. Marijuana plants have been selectively bred to have a lot of THC.

If you think grocery stores are playing tricks on you, they really are

Hemp products contain either minuscule levels or no THC at all. Hempseeds and the oil made from the seeds are already in grocery stores nationwide as food items or ingredients. Hempseeds are rich in heart-healthy omega-3 fatty acids and omega-6 gamma-linolenic acid (GLA) and other nutrients that contain trace or no THC. Consuming hempseeds or hemp oil doesn't cause a high and won't cause you to fail a drug test.

But there is another cannabis compound gaining popularity called cannabidiol (CBD), which can be found in either marijuana or hemp. It doesn't have mind-altering effects and may offer therapeutic benefits. In states where they're legal, CBD from hemp, and both CBD and THC from marijuana, are starting to appear in products such as specialty ice cream, snack bars, beer and cold-brew coffee. This isn't limited to dispensaries; some grocery stores are selling CBD oil.

As a dietitian, I never thought that cannabis would be a topic within my wheelhouse. But more clients are asking about it, and, before looking into it, I wasn't clear on when it's considered a food, drug or medicine -- or even legal or illegal. Here's what I can tell you.

Potential benefits of cannabis

According to a 2017 report by the National Academies of Science, Engineering and Medicine, there is substantial evidence that cannabis or cannabinoids are effective for treating chronic pain, multiple sclerosis spasticity symptoms, and chemotherapy-induced nausea and vomiting.

Initial studies show that CBD oil may be helpful for children with epilepsy, and it is being investigated as a potential treatment for other neurological disorders and mental health and substance abuse issues. CBD oil, THC and marijuana have not been approved by the Food and Drug Administration "for the diagnosis, cure, mitigation, treatment, or prevention of any disease." Medications that contain synthetic THC or similar compounds, however, have been approved by the FDA for specific uses.

What's legal and what isn't? It's complicated

The line between marijuana and hemp seems clear, but U.S. federal law and some state laws disagree. This is where things get even more confusing.

At the federal level, marijuana and hemp extracts such as CBD oil are illegal, Schedule I substances. It was illegal to grow hemp in the United States until the "legitimacy of industrial hemp research" amendment in the 2014 farm bill. Now some states are permitted to grow industrial hemp for research purposes. The Hemp Farming Act of 2018 is a bill that, if passed, will make farming hemp federally legal.

At the state level, things get much more complicated. Some states allow recreational marijuana use; others permit medical marijuana use for specific health issues that differ from state to state; some allow the use of low-THC, high-CBD products for specific medical reasons; and others don't allow the use or sale of marijuana or certain parts of hemp or their extracts, including CBD oil. If you're interested in taking CBD oil or other cannabis products, look into your state's laws carefully first.

Buyer beware

What should consumers know about THC or CBD in food or as extracts? Note that because marijuana and some hemp products are federally illegal, oversight falls to the states. But label laws and quality control differ among states, and, the FDA warns, the amounts of THC and CBD listed on a package aren't necessarily precise. As a result, consumers can't accurately estimate the dosage they're getting. This is a safety concern and is especially worrisome for people who are using these products to try to treat medical conditions.

"The market is unregulated and there are entities marketing less-than-safe and inauthentic products," warns Colleen Keahey Lanier, executive director of the Hemp Industries Association.

While I don't advocate that anyone ingest substances whose benefits are not well studied and may be illegal, there are steps you can take to protect yourself if you do decide to try cannabis products. Keahey Lanier offers the following tips to consumers looking for CBD oil: "Look for brands that offer third-party batch testing not only for the cannabinoid content but also for heavy metals and residual solvents. Stay away from synthetic cannabinoids like 5-fluoro ADB, which may be purposefully mis-marketed as an organic hemp-derived product."

Janice Newell Bissex, a dietitian and holistic cannabis practitioner, recommends her clients take a look at where the product was grown and encourages choosing a whole plant product rather than just an extract of THC or CBD. For example, some whole products contain terpenes, compounds that may have anti-inflammatory, antibacterial effects and anxiety-reducing effects.

With tinctures and products that contain THC, be aware that ingesting the compound means delayed results. This increases the chances that people will consume too much.

There are also concerns about children accidentally ingesting marijuana in foods and beverages, especially in baked goods and candy, although the numbers have been small so far.

It should also be noted that, because of the legal barriers, marijuana and hemp extracts haven't been well studied, so we don't know the long-term effects.

Whether you like it or not, the use of cannabis in food, beverages and supplements is a trend that will continue to grow. That means we're going to need standardization, quality control, accurate labeling and public education - all of which will take time. Until cannabis is regulated as comprehensively as alcohol or medications, consumers and professionals are going to have to educate themselves.

Brissette is a dietitian, foodie and president of 80TwentyNutrition.com. Follow her on Twitter @80twentyrule.

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